A RARE CO-EXISTENCE OF CORONARY ANOMALIES: ANOMALY OF ORIGIN AND DISTRIBUTION TOGETHER WITH ANOMALY OF INTRINSIC CORONARY ARTERY ANOMALY: A CASE REPORT
The co-existence of the Left Circumflex Coronary Artery (LCx) originating ectopically from the right sinus of Valsalva with a Posterior Descending Coronary Artery (PDA) originating from the distal end of the Left Anterior Descending Artery (LAD) i.e. a hyper dominant LAD is, to our knowledge, unreported previously.We describe, a case admitted to our institution with the diagnosis of acute coronary syndrome /NSTEMI/ and coronary arteriography unveiling anomalous origin of a Left Circumflex Coronary Artery from the right coronary sinus of Valsalva near the right coronary ostium AND a Hyperdominant LAD giving off a PDA with small distal Posterolateral Left ventricular branch. This rare co-existence of anomaly is important to keep in mind and be cognizant of the extensive myocardium this type of coronary anomaly perfuse and should be anticipated with high index of suspicion if a patient presents with extensive anterior and inferior wall left ventricular myocardial infarction, which is a common clinical scenario.
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